04 Apr When to Call After Your Retinal Surgery
I want my patients to call me after retinal eye surgery if they develop pain and/or loss of vision. These two symptoms can be signs of either infection or retinal detachment, the two most dreaded complications of retinal surgery .
Eye Infection Can Blind
The most concerning post-operative complication of retinal eye surgery would be infection inside the eye. Infection inside the eye, called endophthalmitis, often leads to blindness.
The most frequent symptoms of endophthalmitis are pain and loss of vision. (Unfortunately, these symptoms are not 100% so please call your own doctor if you are concerned.)
I tell my patients to call if they develop pain that is not relieved by Tylenol, Advil or whatever usually works for headache. Incidentally, I rarely need to give an prescription pain relief for any of my surgeries. An advantage of this is the ability to monitor pain.
Pain can develop for other reasons other than infection, say increased eye pressure, but potentially blinding eye infection is obviously the most concerning.
Fortunately, endophthalmitis is very, very uncommon in retinal surgery.
Signs of Retinal Detachment
Signs of retinal detachment following retinal surgery are not as obvious as compared to naturally occurring retinal detachments (I couldn’t think of a better term.) The usual signs of retinal detachment are flashes, floaters and loss of peripheral vision.
After retinal surgery, vision is usually poor so that the normal signs may be missed.
My advice for may patients is that they call if the vision gets worse, in any way, compared to the first day when the patch comes off.
Compared to cataract surgery, retinal surgery usually does not restore the vision quickly, if at all. I ask my patients to distinguish between actual worsening vision versus vision which fails to improve as quickly as hoped.
In general, if the vision improves or stays the same after the patch is removed…things are fine.
What Does This Mean?
These are my own recommendations for my patients. While I feel these are very good guidelines and have worked well for my patients over the past 20+ years, please follow the directions and recommendations of your personal doctor.
I try to practice medicine as practically as possible. My biggest fears following retinal surgery are infection and retinal detachment. Your doctor may have other concerns or you may have a specific condition or situation where these recommendations don’t apply.
Randall V. Wong, M.D.
Feilx AlveresPosted at 22:47h, 10 April
Five months ago I had lazer and chrio on a large retinal tear. So far ok no improvement in vision however not worse and seems stable. Recently Im experiencing a sensation of pressure around the eye and or a feeling that something is in my eye that comes and goes but my pressure tested ok.. no paini to speak of. I noticed if I work on my computer and blackberry a lot the sensation seems to come on. My doctor asked me to try advil and see if it relieves it first. Im only on advil one day but seems to help a little. Please advise on your thoughts on this.
Randall V. Wong, M.D.Posted at 09:06h, 23 April
Hard for me to comment without the ability to examine you. Often, a “pressure” sensation may be due to sinus disease/problems. Make sure you pay attention to your doctors’ advice.
Doug PribblePosted at 19:07h, 19 June
11 months ago I was diagnosed with retinal tear with detachment. Pneumatic bubble and cyro on that, but 1 week later developed 2 more small tears/detachments. Ended up getting vitrectomy w/ scleral buckle, laser, and gas bubble. Good progress since – lost a tiny bit of acuity and night vision (corrected 20/20 now as before but a wee bit of monocular double vision) but over all very good.
One worry – a very small, almost stationary round bubble-like translucent floater in operated eye. It appears from my visual perspective at about “3 o’clock” – always from the same place – especially when turning head right to left, or looking right to left with eyes. it then appears to drift ever so slightly downwards – although sometimes it appears to stay stationary. It usually disappears after about 4 or 5 seconds.
My retina surgeon has done a dilated exam and cannot see anything and says it may be a bit of remaining vitreous. My ophthalmologist (different doc) also thinks this is the case.
Is it common for a floater to appear almost a year after surgery?
Should I be concerned about it’s in a relatively stationary position (as were my detachments?)
How much vitreous is left after vitrectomy, is it usually visible, and why would it appear bubble-like?
In case it’s relevant: I am highly myopic (-9L and post op -10.5R) and doc says I see things (like peripheral laser ‘scars’) most folks can’t – perhaps because of high myopia?
Thanks for all the information you provide us Dr. Wong.
Randall V. Wong, M.D.Posted at 18:14h, 22 June
1. Agree probably in the vitreous.
2. Floater may not be new, but just shifted or migrated to a part of your eye where it is now visible.
3. Removing all vitreous is impossible, especially with a lens in place. It is likely that what ever vitreous was left (it is very adherent to the anterior retina) may have partially separated from the surface of the retina to allow relative repositioning.
4. Usually is not visible, but two docs have looked and they can’t see….most likely vitreous (meaning, there is no pathology causing the floater). We docs cant’ always see “your” floater.
Thanks for the kind remarks!
Randall V. Wong, M.D.
lizaPosted at 18:14h, 15 March
please can you tell me what signs to look out for after detached retina repair today
Randall Wong, M.D.Posted at 18:53h, 20 August
Same as before detachment – sudden increase in flashes, floaters or decreased vision.
Patric criglerPosted at 14:09h, 16 August
I recently had scleral buckle only for small tear in retina, but since surgery I’ve had really bad headaches, is this normal after surgery, and does it usually subside?
Randall Wong, M.D.Posted at 17:48h, 20 August
There can be many reasons for “headaches” related to recent eye surgery, especially for a scleral buckle. Without the ability to examine you, I’d only be guessing. Sorry for such a weak response.
john swiftPosted at 19:53h, 29 September
it’s been 5 months since R.D. repair, buckle, remove old lens, gas bubble. it’s been 3 1/2 months since gas dissipated. no vision since then. it’s been 1 week since a new lens was inserted. i am on cipro and durezol. no pain but some swelling. when will my vision return? i can barely see the fingers on my outstreched hand. is this situation common ? thank you very much
Randall Wong, M.D.Posted at 21:06h, 20 May
I have not idea as I don’t know your particular situation and do not have the luxury of examining you.
FrancisPosted at 08:10h, 10 March
I had a retina horseshoe tare back in November 2022, had laser surgery done and afterwards I had a small retina detachment, then February 2023, I had noticed my vision was getting increasingly worse every day until I woke up and had flashing lights and called my surgeon, I ended up having scar tissue buildup because of the laser surgery, I had vitrectomy, scar tissue removed and SF6 gas bubble, I did great for the first two days then I have had excruciating pain in the back of my eye and the whole eye socket and the top of my head of the eye I had the surgery on, went to emergency room and then was seen by a specialist and then back to my own surgeon and then followed by my optamoligist, my eye pressure was in the normal range 17, no signs of infection had a CT Scan done and it was normal, the only thing all of these doctors said was I had a haemorrhage at the back of my eye, which made it impossible for them to be able to see anything and lots of inflammation, was put on ketrolac which is hit or miss with helping with my pain, it’s been 3 weeks of hell, I’m diabetic so a week ago decided I should check my blood sugar levels and discovered I was extremely high 30+ , so now I’m taking injections of insulin to help bring my blood sugar levels down and it has made a big improvement, however I’m still having this terrible pain, everything I’ve googled I haven’t come across anyone else who has this pain that I have, any input would be greatly appreciated.